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https://www.readbyqxmd.com/read/28910474/atropine-eye-drops-a-proposed-field-expedient-substitute-in-the-absence-of-atropine-autoinjectors
#1
Christopher J Calvano, Robert W Enzenauer, Derek L Eisnor, Robert A Mazzoli
Nerve agents are a threat to military and civilian health. The antidote, atropine sulfate, is delivered by autoinjector, which is a limited resource. We propose the use of 1% atropine ophthalmic solution (supplied commercially in 5mL or 15 mL bottles) via oral, ocular, and intranasal administration as an expedient substitute in austere environments.
2017: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/28910473/optimization-of-simulation-and-moulage-in-military-related-medical-training
#2
Christopher Petersen, Stephen C Rush, Isabelle Gallo, Bryan Dalere, Brian Staak, Litt Moore, Win Kerr, Matthew Chandler, Will Smith
Preparation of Special Operations Forces (SOF) Medics as first responders for the battle space and austere environments is critical to optimize survival and quality of life for our Operators who may sustain serious and complex wounding patterns and illnesses. In the absence of constant clinical exposure for these medics, it is necessary to maximize all available training opportunities. The incorporation of scenario-based training helps weave together teamwork and the ability to practice treatment protocols in a tactical, controlled training environment to reproduce, to some degree, the environment in and stressors under which care will need to be delivered...
2017: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/28910466/surgical-instrument-sets-for-special-operations-expeditionary-surgical-teams
#3
Diane F Hale, Justin C Sexton, Linda C Benavides, Jerry M Benavides, Jonathan B Lundy
BACKGROUND: The deployment of surgical assets has been driven by mission demands throughout years of military operations in Iraq and Afghanistan. The transition to the highly expeditious Golden Hour Offset Surgical Transport Team (GHOST- T) now offers highly mobile surgical assets in nontraditional operating rooms; the content of the surgical instrument sets has also transformed to accommodate this change. METHODS: The 102nd Forward Surgical Team (FST) was attached to Special Operations assigned to southern Afghanistan from June 2015 to March 2016...
2017: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/28910465/combat-trousers-as-effective-improvised-pelvic-binders-a-comparative-cadaveric-study
#4
Andrew Loftus, Rhys Morris, Yasmin Friedmann, Ian Pallister, Paul Parker
BACKGROUND: Improvised explosive devices and landmines can cause pelvic fractures, which, in turn, can produce catastrophic hemorrhage. This cadaveric study compared the intrapelvic pressure changes that occurred with the application of an improvised pelvic binder adapted from the combat trousers worn by British military personnel with the commercially available trauma pelvic orthotic device (TPOD). METHODS: Six unembalmed cadavers (three male, three female) were used to simulate an unstable pelvic fracture with complete disruption of the posterior arch (AO/OTA 61-C1) by dividing the pelvic ring anteriorly and posteriorly...
2017: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/28885974/melanoma-in-an-active-duty-marine
#5
Samantha J Bartling, Shayna C Rivard, Jon H Meyerle
Given that the majority of active duty service members are young and healthy, potentially malignant diagnoses such as skin cancer may be overlooked. Although melanoma accounts for only approximately 1% of skin cancers, it causes the greatest majority of skin cancer deaths. We present the case of a 27-year-old active duty Marine who presented with a hyperpigmented macule at his lateral neck that was a malignant melanoma in situ. This article reviews risk factors for the development of melanoma, offers guidelines for primary care providers, reviews resources for providers in a deployed or austere environment, offers recommendations for prevention and early diagnosis, and discusses follow up...
September 2017: Military Medicine
https://www.readbyqxmd.com/read/28885970/essential-medications-for-patients-with-suspected-or-confirmed-ebola-virus-disease-in-resource-limited-environments
#6
William F Pierce, Selena D Ready, John Tyson Chapman, Corrinne Kulick, Anastasia Shields, Jialynn Wang, Kimberly Andrews, Richard W Childs, Carlos Bell, Alexandr Kosyak, Jade Pham
BACKGROUND: In 2014, the U.S. Public Health Service (USPHS) Commissioned Corps deployed to Monrovia, Liberia, to operate a 25-bed Ebola treatment unit (ETU) constructed by the U.S. Military. The ETU was named the Monrovia Medical Unit (MMU) and was constructed from an U.S. Air Force Expeditionary Medical Support (EMEDS) unit with modifications on the basis of consultation from Médecins Sans Frontières, the World Health Organization, and expert panels from the U.S. Department of Defense and Department of Health and Human Services...
September 2017: Military Medicine
https://www.readbyqxmd.com/read/28885945/effect-of-novel-continuing-medical-education-curriculum-on-attitudes-and-understanding-of-primary-care-medicine-for-the-naval-surface-provider
#7
Joseph LaGrew, Cameron Hightower, Terrie Vasilopoulos
INTRODUCTION: Naval Surface Forces provide care in austere environments with unique facility, personnel, and material limitations that can put the patient at risk without proper consideration of these circumstances. Tailored shipboard education currently exists but is greatly dependent on the time, preferences, expertise, and ability of a single teaching officer, allowing for significant variability in the level of training. MATERIALS AND METHODS: One hundred and twenty-two individuals were trained in 19 topics presented over 12 months through the Naval Surface Forces Pacific Command Medical Readiness Division to all surface providers on Naval Base San Diego...
September 2017: Military Medicine
https://www.readbyqxmd.com/read/28810961/resuscitation-of-hypotensive-traumatic-brain-injured-animals-with-spray-dried-plasma-does-not-adversely-alter-physiology-and-improves-blood-brain-barrier-function
#8
Steven McDaniel, Stephanie Golla, Anthony N Moore, Joe DaCorta, Arthur Bode, Shibani Pati, Pramod K Dash, Jing Zhao
INTRODUCTION: According to the Defense and Veterans Brain Injury Center and the Armed Forces Health Surveillance Center, the number of soldiers who have sustained a traumatic brain injury (TBI) has risen dramatically over the past decade. Studies have shown that brain damage can be exacerbated if blood loss occurs (often occurring in polytrauma). As blood supply is critical for brain function and survival, TBI patients must be properly resuscitated to maintain blood volume, blood pressure, and cerebral perfusion...
July 2017: Military Medicine
https://www.readbyqxmd.com/read/28798198/wearable-ballistocardiogram-and-seismocardiogram-systems-for-health-and-performance
#9
Mozziyar Etemadi, Omer T Inan
Cardiovascular diseases (CVDs) are prevalent in the US and many forms of CVDs primarily affect the mechanical aspects of heart function. Wearable technologies for monitoring the mechanical health of the heart and vasculature could enable proactive management of CVDs through titration of care based on physiological status, as well as preventative wellness monitoring to help promote lifestyle choices that reduce the overall risk of developing CVDs. Additionally, such wearable technologies could be used to optimize human performance in austere environments...
August 10, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28794010/an-unusual-case-of-an-immersion-hand-presentation-in-a-young-signaller-operating-in-the-jungle-in-belize
#10
Kirstie E Forbes, P Foster
Belize, hosting one of the British Army's overseas training areas, provides access to challenging terrain and austere environments, which allows the delivery of training to soldiers on survival and combat within the jungle environment. A 26-year-old infanteer on exercise in Belize presented with progressive bilateral dry, painful, oedematous hands, secondary to the harsh environmental conditions of the jungle and inadequate drying of his hands resulting in his inability to perform his combat duties. The symptoms completely resolved with drying, emollient application and analgesia...
August 8, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/28720190/clinical-herpes-zoster-in-antarctica-as-a-model-for-spaceflight
#11
David P Reyes, Alaina A Brinley, Rebecca S Blue, Stephen K Gruschkus, Andrew T Allen, Scott E Parazynski
INTRODUCTION: Antarctica is a useful analog for spaceflight, as both environments are remote, isolated, and with limited resources. While previous studies have demonstrated increased asymptomatic viral shedding in both the Antarctic and spaceflight environments, clinical manifestations of reactivated viral disease have been less frequently identified. We sought to identify the incidence of clinical herpes zoster from viral reactivation in the Antarctic winter-over population. METHODS: Medical records from the 2014 winter season were reviewed for the incidence of zoster in U...
August 1, 2017: Aerospace Medicine and Human Performance
https://www.readbyqxmd.com/read/28705994/wearable-brain-imaging-with-multi-modal-physiological-recording
#12
Gary E Strangman, Vladimir Ivkovic, Quan Zhang
The brain is a central component of cognitive and physical human performance. Measures including functional brain activation, cerebral perfusion, cerebral oxygenation, evoked electrical responses, and resting hemodynamic and electrical activity are all related to, or can predict health status or performance decrements. However, measuring brain physiology typically requires large, stationary machines that are not suitable for mobile or self-monitoring. Moreover, when individuals are ambulatory, systemic physiological fluctuations-e...
July 13, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28704087/resilience-as-part-of-nursing-education-supporting-nurses-in-times-of-austerity
#13
Janet Scammell
Janet Scammell, Associate Professor (Nursing), Bournemouth University, discusses the challenging environment nurses are working in and the role of resilience in creating a sustainable NHS workforce.
July 13, 2017: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/28697026/smartphone-based-mobile-thermal-imaging-technology-to-assess-limb-perfusion-and-tourniquet-effectiveness-under-normal-and-blackout-conditions
#14
Morgan R Barron, John P Kuckelman, John M McClellan, Michael J Derickson, Cody J Phillips, Shannon T Marko, Joshua P Smith, Matthew J Eckert, Matthew J Martin
BACKGROUND: Over the past decade there has been a resurgence of tourniquet use in civilian and military settings. Several key challenges include assessment of limb perfusion and adequacy of tourniquet placement, particularly in the austere or pre-hospital environments. We investigated the utility of thermal imaging to assess adequacy of tourniquet placement. METHODS: The FLIR ONE™ smartphone-based thermal imager was utilized. Ten swine underwent tourniquet placement with no associated hemorrhage (n=5) or with 40% hemorrhage (n=5)...
July 8, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28692011/far-forward-diagnostics-in-toxic-industrial-chemical-and-material-exposure-scenarios-and-biomarker-identification
#15
Charles C Young, Danielle L Ippolito
: This study describes key technical solutions for detecting environmental toxicants and diagnosing adverse health effects in military operational settings as outlined at a symposium cosponsored by the Department of Defense and the Johns Hopkins University-Applied Physics Laboratory (October 27 to 28, 2015). Such technologies are urgently needed in order to provide critical decision-aid tools and prognostic assessment of potential clinical sequelae. This review summarizes the state-of-the-science on (1) prioritization of adverse health effects, (2) existing technologies and diagnostic tools available for use in theater, (3) challenges to advancing diagnostic tools far-forward, and (4) the potential utility of anchoring diagnostic tools to adverse outcome pathways...
July 6, 2017: Journal of Occupational and Environmental Medicine
https://www.readbyqxmd.com/read/28659166/familiar-ethical-issues-amplified-how-members-of-research-ethics-committees-describe-ethical-distinctions-between-disaster-and-non-disaster-research
#16
Catherine M Tansey, James Anderson, Renaud F Boulanger, Lisa Eckenwiler, John Pringle, Lisa Schwartz, Matthew Hunt
BACKGROUND: The conduct of research in settings affected by disasters such as hurricanes, floods and earthquakes is challenging, particularly when infrastructures and resources were already limited pre-disaster. However, since post-disaster research is essential to the improvement of the humanitarian response, it is important that adequate research ethics oversight be available. METHODS: We aim to answer the following questions: 1) what do research ethics committee (REC) members who have reviewed research protocols to be conducted following disasters in low- and middle-income countries (LMICs) perceive as the key ethical concerns associated with disaster research?, and 2) in what ways do REC members understand these concerns to be distinct from those arising in research conducted in non-crisis situations? This qualitative study was developed using interpretative description methodology; 15 interviews were conducted with REC members...
June 28, 2017: BMC Medical Ethics
https://www.readbyqxmd.com/read/28630743/comparison-of-five-video-assisted-intubation-devices-by-novice-and-expert-laryngoscopists-for-use-in-the-aeromedical-evacuation-environment
#17
Matthew C Wallace, SSgt Tyler Britton, Robbie Meek, Sharon Walsh-Hart, Col Todd E Carter, Steven J Lisco
BACKGROUND: The critically ill or injured patient undergoing military medical evacuation may require emergent intubation. Intubation may be life-saving, but it carries risks. The novice or infrequent laryngoscopist has a distinct disadvantage because experience is critical for the rapid and safe establishment of a secured airway. This challenge is compounded by the austere environment of the back of an aircraft under blackout conditions. This study determined which of five different video-assisted intubation devices (VAIDs) was best suited for in-flight use by U...
2017: Military Medical Research
https://www.readbyqxmd.com/read/28628601/the-damage-control-surgery-in-austere-environments-research-group-dcsaerg-a-dynamic-program-to-facilitate-real-time-telementoring-telediagnosis-to-address-exsanguination-in-extreme-and-austere-environments
#18
Andrew W Kirkpatrick, Jessica L McKee, Paul B McBeth, Chad G Ball, Anthony LaPorta, Timothy Broderick, Tim Leslie, David King, Heather E Wright Beatty, Jocelyn Keillor, Homer Tien
Hemorrhage is the most preventable cause of posttraumatic death. Many cases are potentially anatomically salvageable, yet remain lethal without logistics or trained personnel to deliver diagnosis or resuscitative surgery in austere environments. Revolutions in technology for remote mentoring of ultrasound and surgery may enhance capabilities to utilize the skill sets of non-physicians. Thus, our research collaborative explored remote mentoring to empower non-physicians to address junctional and torso hemorrhage control in austere environments...
July 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28601213/treatment-of-thoracic-trauma-lessons-from-the-battlefield-adapted-to-all-austere-environments
#19
REVIEW
Lanny F Littlejohn
Severe thoracic trauma in the backcountry can be a formidable injury pattern to successfully treat. Traumatic open, pneumo-, and hemothoraces represent some of the most significant patterns for which advanced equipment and procedures may help leverage morbidity and mortality, particularly when evacuation is delayed and environmental conditions are extreme. This paper reviews the development of successful techniques for treating combat casualties with thoracic trauma, including the use of vented chest seals and the technique of needle thoracentesis...
June 2017: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/28601206/prolonged-field-care-beyond-the-golden-hour
#20
REVIEW
Sean Keenan, Jamie C Riesberg
Prolonged field care (PFC) has emerged as a recent area of focus for US military Special Operations Forces (SOF) medical experts. Focused on the current reality of providing medical care to military forces often deployed in remote and austere locations far from medical support or a robust casualty evacuation chain, PFC encompasses evolving operational situations not unlike many wilderness medicine practice environments. SOF currently operates in all areas of the world and on a variety of different missions, which finds these small teams far from the accustomed practice environment of robust deployed medical infrastructure commonly seen during the last 15 years of military conflicts...
June 2017: Wilderness & Environmental Medicine
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